Messages for clinicians

Yeah, “How are you doing,” and ixnay the lecture. I mean the least, at least post injury. I mean, once they are able to even process what the hell happened, that’s--it was overboard. It was absolutely overboard. And it’s not that, it’s not like I didn’t think they are just in here to lecture me. They don’t give a shit. These are docs that I was hip to hip with in a person’s body the week before. Like these are my colleagues. So, I knew it was coming from a genuine place. But their role as a trauma surgeon took over their role as a friend and colleague. And then it became a, “I know, I know what we’re saying here. Let’s just, let’s stop.” Like, I’m still trying to figure out I just shot myself in the ass, man. Of course, I should have checked it. And I think being there to be compassionate and instead saying, you know, “How are you doing?” and you know, “You’ve got to be freaked out. I know I would be.” And go there. Patient’s gonna to beat themselves up plenty enough, far more than any surgeons gonna.  

The rapport is going to be built with that social worker and maybe there needs to be more because usually one per unit is, you’re smoked already. But that is, once that rapport is made, having that same person make that follow up four weeks later. “Hey, you know, it’s me. Just want to see how you’re doing, you know. You went through some shit, and I know we only talked about some stuff when you were here. You know, is that stuff coming back to you at all? Are you doing okay?” And then based on those answers, you know, you maybe make the therapy referrals at discharge. But then, that’s when you follow up to see if they took them up on that. And you go, “Okay, you know, I understand, you know, you don’t want to talk. Like I get it’s embarrassing. I get you’re angry at yourself. But you know, listen, I...” and then have someone, whether it’s bullshit or not, have a relational thing of, “When I went through some really ugly shit. I didn’t pursue any help. I needed to just deal with it and drive on. And I was a mess for a long, long time.”  

Yeah, just more – I mean one thing, I appreciate the VA for sure. One thing sometimes they miss is the empathy aspect, you know? It’s too automatic, too robotic at times. And so, I think, you know, sometimes they just forget that these are fragile people that you’re dealing with. They’re strong, but they’re fragile. So, I think you have to – there’s a level of fragility within any Veteran, whether people understand it or not. So, I think they just need to be more gentle with their approach and, you know, their questioning with – you know – just be more gentle and more aware. That’s all.

Well, I did say that this was embarrassing. You know the whole situation was embarrassing just having to go to the hospital, you know. And tell them exactly, you know, what happened. But, I felt kind of like, you know, the main attraction, I guess. Because at least with the physician and the nurses, you know, they came in, you know. They’ve never had somebody, you know, come into the hospital especially with the type of injury that occurred that, you know, that was self-inflicted. They’d never seen an injury like that. So, I don’t know if it was just, I was made to be an example, you know, where everybody – the doctors came in, you know, and wanted to see what one of those pellets do to you. You know, the type of injury that I inflicted on myself with a pellet rifle, you know, a pellet gun. And I just felt kind of – I don’t know, embarrassed. But yeah, the doctors, you know, kind of looked at it, you know, and like with a curiosity, I guess. And this felt – I don’t know. I just felt – I don’t know if I’m answering your question correctly or not. But I just felt kind of embarrassed just to be like a pin cushion, I guess, you know, where everybody just prodded me and looked at it, you know, and examined it, and made a big example. The main story of the day. “Hey, I’ve got a guy here that shot himself with a pellet rifle. Want to come see?”  

I think the VA really lacks, sometimes in a big way, cultural sensitivity. I think the VA really needs to get on board with being a lot more culturally sensitive. Providers just really need to be aware that Veterans are not going to give up their firearms, and it might not be for the reasons they think. They might not realize that, like, you have, that that's a peaceful thing for us to go shut out the world for an hour.

So, if I put aside my belief that a person should never have to interact with gun violence, or guns, or gun culture if they never want to. Putting that aside for a second, I am curious about the level of training that clinicians receive in understanding gun culture, understanding that kind of terminology, understanding how these things happen. I don’t know to what degree they receive that kind of training because I know I can tell you right away when I’m listening to a script on television and the person who wrote that script doesn’t know a thing about firearms, and I would know if a healthcare provider who was talking to me didn’t know anything about firearms, and if I had suffered an injury, or if my spouse, or my child, or if someone had suffered an injury as a result of firearms, and I felt in that moment of trauma that I had to train the clinician on what happened, that would be immensely frustrating. Just immensely frustrating. 

So, I would like to think that even though I wish that they never had to deal with firearm injuries, they do have to deal with firearm injuries. So, if there was any type of training that they could take to, at least, be aware of the terminology and what the person and their family who are dealing with that injury, if there could be some commonality--they would have to learn it for other types of injuries, I imagine, there would have to be some cross-training in things that they don’t understand, and I think this would just be another thing in their arsenal. And so, I would like to think that clinicians would be smarter than to ask, "Well, why didn’t you just do XYZ?", when XYZ was not possible. And so, having some training about that would really help, I think.

Maybe trying to just double-check mentally-wise if the patient’s doing okay. I guess I was very adamant. I think they asked me multiple times if I need to seek mental health. I just felt comfortable enough doing it without it. But some people may be not wanting to do it, but deep down probably do need it. So, maybe just being a little bit more persistent, just double-check and like, “No pressure. Are you okay? Do you need therapy?” would probably be my biggest advice I guess, because I think some people would just be too uncomfortable taking that leap maybe if it wasn’t for them being just a little bit more persistent, you know? And like, “We’re here to help you if there’s anything we can do, or try to help.”

I think that would be more support groups I think more effective. Like cancer support groups and you know, victims, you know, victims of domestic violence support groups, because it’s--we’re the subject matter experts and we’ve been through it. And not to get down on the healthcare field or, it’s--if they become a doctor or a nurse to provide medical care and we’re asking them, putting all this extra stuff on them that they might not be trained for, like our, like law enforcement. And I think we do that a lot to our medical professionals. That wasn’t what they signed--they had this dream as a kid to be a doctor to save lives. And they spend 12, 16 years in college and start training. Then we say, “Oh, by the way, you need to keep this, talk this guy down like... I know how to fix his heart. I don’t know how to fix his head!” So, I think we dump a lot on our nurses and doctors, that it would be great if they could find a way to do it, but I don’t really think it’s their job. It might be because we’re just trying to figure out how to, nobody knows how to fix this. “Well, it’s your job, it’s your job.” Maybe someone will come up with the right answer. I think a lot of the emotional support is better served, in my personal opinion, in support groups and along them lines with people who have experienced the same thing.  

So, my initial doctors, when I was still in the hospital, were doom and gloom. My physician—my PA down here, who was my primary care at the time, “Well, let me know. I don’t think it’s as bad as they were saying. But, you know, let’s work hard.” He gave me more inspiration than they did. Well, they gave me a lot of inspiration, don’t get me wrong, because now I had to prove them wrong. But he pointed me towards what I needed to be looking at, what I needed to be doing.

These physicians need to start talking more with the surgeons, start talking more with physical therapists in that area, and start getting more information before they just start throwing the doom and gloom right off the bat. Because had I known that I could’ve gotten my collar bone fixed prior to building my arm up for a year and a half, that I could’ve got it fixed right after I got shot, I probably would’ve, because it would’ve made it a little bit easier on me. I still wouldn’t have three of the muscles in my back and my shoulder, but I would have—I wouldn’t look, you know, it wouldn’t look quite so bad as it does. But nobody ever thought about that part.

I guess focus more on the individual instead of the method. Not everything's defined on a protocol or a policy. You've got to find the individual and you've got to find what works for them, not, you know, “Well, this worked for Joe so this should work for Bob.” And not a psychiatrist, a psychologist.  

What kind of medical care? There’s none. There is no medical care there. The other day up there when that doctor was on the TV talking to me, and I asked for an inhaler, she tells me, “Well you know, sir, if you’d quit smoking, you’d breathe better.” I says, “Yeah, ma’am, I do know that.” I said, “I also know if I didn’t stick a 12-gauge barrel in my mouth and blow all my sinuses out I’d breathe better. And that’s why I got an inhaler. Well, you know if you’d have read my medical record, you’d see why I was prescribed the inhaler too.”